“肾气热则骨枯髓减”探讨儿童糖皮质激素性骨质疏松的发病机制  

Investigation of the pathogenesis of glucocorticoid-induced osteoporosis in children based on the theory of marrow loss and bone exhaustion caused by warm kidney qi

作　　者：马涵琳 张霞[1,2,3] 张帅 韩姗姗[1,2,3] 任献青[1,2,3] 丁樱[1,2,3] MA Hanlin;ZHANG Xia;ZHANG Shuai;HAN Shanshan;REN Xianqing;DING Ying(Pediatric Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学儿科医学院,河南郑州450000 [2]河南中医药大学第一附属医院,河南郑州450000 [3]河南中医药大学,河南郑州450000

出　　处：《中国骨质疏松杂志》2023年第10期1528-1532,共5页Chinese Journal of Osteoporosis

基　　金：中国民族医药学会科研项目(20212Z1183-400617);河南省中医药科学研究专项课题(2019ZY1010,2021ZY2045);河南省科技厅-河南省科技研发计划联合基金项目-优势学科培育类(222301420078);河南省自然科学基金面上项目(222300420488);2022年度河南省健康中青年学科带头人培养项目[豫卫人(2022)26号]。

摘　　要：糖皮质激素性骨质疏松(glucocorticoid-induced osteoporosis,GIOP)是儿童常见的继发性骨质疏松症。因其影响儿童骨骼的正常发育,导致生长发育障碍,降低患儿生活质量,逐渐在世界范围内受到广泛关注。GIOP归属于中医“骨枯”“骨痿”范畴,其产生与“肾气热”密切相关。肾为水脏,水不胜火,则热灼精枯,骨失濡养发而为病。糖皮质激素属阳刚燥烈之品,为GIOP发病的源头,过用可出现热盛阴虚的证候,与“肾气热则骨枯髓减”所述病机相吻合。本文基于此理论,结合现代医学研究探讨GIOP的中医发病机制,以期为临床辨证治疗提供思路。Glucocorticoid-induced osteoporosis(GIOP)is the most common secondary osteoporosis in children.Because it affects the development of children’s bones and leads to growth development disorders,and reduces the quality of life in children,it has gradually attracted wide attention worldwide.GIOP is classified to the category of bone loss and bone impotence in traditional Chinese medicine.Its occurrence is closely related to warm kidney qi.Kidney is the bank of water.Water is conquered by fire.When heat causes marrow exhaustion,the bone is suffered from non-nourishment.Glucocorticoid is the source of GIOP.It belongs to the hot and acrid in traditional Chinese medicine.Overdose of glucocorticoids may cause consumption of kidney essence due to intense heat,which is consistent with the theory of marrow loss and bone exhaustion caused by warm kidney qi.Based on this theory,this paper explores the pathogenesis of GIOP in traditional Chinese medicine combined with modern medical research,in order to provide ideas for clinical dialectical treatment.

关 键 词：糖皮质激素性骨质疏松 儿童 骨痿 中医药 病机 

分 类 号：R272[医药卫生—中医儿科学] R681[医药卫生—中医学] R729